The following came off the Internet, via the Society of Gynecologic Oncologists:
[Shortened a little, but all main points here]
CHICAGO, AUGUST 7, 1996 -- A startling new study released today in this
month's issue of the journal Gynecologic Oncology....suggests that
shortening the infusion time of paclitaxel (taxol) when given with
cisplatin chemotherapy increases the incidence of peripheral nerve damage
-- often severely affecting the use of patients' hands and feet.
Debate has surrounded how to best administer these agents in order to
maximize their effectiveness while minimizing their toxicity. Recent
economic pressures from insurance companies have favored the use of a
shorter chemotherapy infusion time and an outpatient setting. Hoping to
find an effective chemotherapy regimen that could be administered
economically, researchers at the Cleveland Clinic Cancer Center, Ohio,
treated 38 cancer patients with the regimen of three-hour Taxol infusion
with cisplatin and compared them with a similar regimen given over 24
hours.
The researchers were surprised to find that 71% of the patients receiving
the three-hour treatment program experienced some degree of neurologic
toxicity -- nerve damage commonly associated with numbness and burning
sensations, especially in the hands and feet.
"We know the combination of paclitaxel and cisplatin is very effective
therapy. However, whatever cost savings may be gained from the shortened
regimen may not be worth it if it means a diminished quality of life for
our patients" said research team leader, Maurie Markman, MD, Cleveland
Clinic Foundation.
If further research confirms the high incidence of neurotoxicity suggested
by this study, physicians will have to consider other options already being
explored. Some of these possibilities include substituting carboplatin for
the more neurotoxic cisplatin when chemotherapy combinations include taxol,
using different doses or schedules of taxol, or using additional
neuroprotective agents to prevent toxicity from the three-hour infusion
setting.
"The goal is to find a treatment that meets the economic demands of managed
care without threatening the quality of life of our patients," said David
M. Gershenson, M.D., Society of Gynecologic Oncologists President.
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I hope the above is helpful to someone!
Helen Henner